Endocrine Abstracts

JOINT150

Background and Aims: Immune modulation of type I diabetes has failed in the last 90 years ago. Increase of C-Peptide has never been seen. Based on experience with harmless immune modulatory drugs in other disease such as alopecia areata, multiple sclerosis, and …. we tried to treat type I DM in the last 7 years ago. The treatments were changed gradually and the most effective protocol is presented.

Materials and Methods: Eleven hundred eighty-two patients were treated with Azithromycin 250mg, Vit A 25000IU twice weekly, and Atorvastatin 10-40mg every night as the immune modulatory block. Dapagliflozin (or Empagliflozin), Glucophage and Pioglutazone were used to reduce the need for insulin. In refining and defining response rate, serum fasting and 2hpp Insulin and C-Peptide, HbA1C, anti-Gad and anti-Islet cell Ab were measured at beginning and every 3 months.

Results: Hundred percent of the patients responded to at least one of the seven parameters with a reduction of HbA1c at 1.4-9.4 percent. Patients could omit their short acting insulin at evening, morning and noon in 100, 87 and 69% respectively. Reduction of anti-GAD and Anti Islet cell AB were encountered in 96 and 92 percent from a high of up to 2000 and 150 down to below 5 and 1.2. Fasting and 2hpp Insulin, fasting and 2hpp C-Peptide were increased in 86%, 88%, 68% and 82% from a low of 0.2, 0.4, 0.001, 0.001 to a high of 4.2, 16.2, 0.3 and 7.6 respectively. Three hundred eighty-eight (32.8%) patients discontinued their insulin completely and 198 (16.7%) awaits this.

Discussion: The astonishing results of increased C-Peptide with declaration of 2hpp C-Peptide as a novel response marker denotes that either increased secretion of insulin or increased beta cell proliferation (like DYRK-1 pathway) is possible in vivo. More sophisticated techniques are needed.